Group Health Insurance
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10-02-2017 by Colleen King
Yesterday was October 1st, the beginning of what we agents AND Medicare refer to as the Medicare Marketing Season. This is the point in time where we can start to discuss what's coming up in plans for the coming year. And you can tell it's the 'marketing' season, because all those god awful commercials start, you're getting tons of stuff in the mail, and even the radio is blaring about different plans, different benefits. But at this point we can only talk about it, we can't accept applications for anything. That start October 15th. At this time we can barely get supplies, because even though we've passed all sorts of certifications, and have been sworn to NOT discuss anything for 2018 outside of the agent-carrier circle, the carriers are still paranoid that someone's going to let the benefits out of the bag before October 1. But in the next 2 weeks, UPS and FedEx are going to be really busy.
All this stuff I"m referring to pertains to Medicare Advantage plans (MAPDs) and Part D Drug plans (PDPs). It doesn't' apply to Medicare Supplements, they are regulated differently. There are many kinds of MAPDs, but in my area, the Los Angeles/Orange County/Ventura County/Riverside/San Bernardino area, most of these are Medicare HMOs. There are a very few Medicare Advantage PPOs and a variety of other plan types that get confusing to discuss but I'm going to focus a bit on the Medicare HMOs. A lot of people cringe at the thought of an HMO, but these can be pretty amazing.
I'm not going to get into specific benefits of any plans, nor name any specific plans, because that gets into marketing and advertising, which means I have to submit what I'm writing about to that particular carrier potentially, and they have to send it to Medicare for approval. I'd rather just tell you about a couple of things I've found interesting. It's not uncommon for a Medicare HMO's network to be larger than a commercial HMO, the kind you may have had when you were working. The reality is, doctors are realizing their client base is aging, so even if they don't take 'regular' HMOs they may take a Medicare HMO. It's pretty easy to figure out, just ask your agent to check who your preferred doc is contracted with.
One thing that was a bit of a stand out to me is a fairly new benefit, not all carriers have it, but if you are looking at MAPDs, see if there is an 'OTC' benefit--this Over The Counter benefit will cover things like your nonprescription vitamins, bandaids, various things like that. You generally have to order these things from their vendor. There is a quarterly amount allocated, some carriers will allow unused portions to roll over, some not. But look for it if you're evaluating Medicare HMOs, it's a nice benefit to have!
So now's the time to figure out what to do for 2018 either for yourself or your parents. And don't go it alone, find an agent who is certified with several different carriers. it's 'free help' to you, and you end up having just one agent calling you back to follow up, not one from each company you called for information.